Recap: Why you should be wary of ‘low fat’ foods | Sarah Berry

Summary

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ZOE Science & Nutrition: Recap – Why You Should Be Wary of ‘Low Fat’ Foods

Guest: Prof. Sarah Berry
Host: Jonathan Wolf
Date: September 30, 2025

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Episode Overview

This episode explores the complex relationship between dietary fats, cholesterol, and heart health. Host Jonathan Wolf and nutrition scientist Professor Sarah Berry dissect longstanding myths around "low fat" foods, clarify the true impact of cholesterol in our diets, and offer practical, evidence-backed strategies for making better food choices for heart health.

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Key Discussion Points & Insights

1. Cholesterol: What Is It, and Why Do We Need It?

[00:46–02:27]

• Cholesterol is a lipid (fat) essential for bodily functions, hormone production, vitamin D synthesis, bile acid formation, and building cell membranes.
• “Without cholesterol, we would be in a little bit of trouble.” — Sarah Berry [01:19]
• The body produces cholesterol on its own because it’s vital for survival.

2. Dietary vs. Blood Cholesterol

[01:48–02:25]

• Dietary cholesterol (cholesterol in foods like eggs) has minimal impact on the cholesterol circulating in our blood.
• “The cholesterol that we eat... actually has very minimal impact on the cholesterol that circulates in our blood.” — Sarah Berry [02:14]

3. Good vs. Bad Cholesterol: LDL & HDL

[02:43–05:39]

• LDL (Low Density Lipoprotein) cholesterol is considered “bad” because it can cross into arterial walls and cause buildup (atherosclerosis), eventually leading to heart attacks.
• HDL (High Density Lipoprotein) cholesterol is “good” — it helps remove cholesterol from the bloodstream.
• The difference between LDL and HDL is the “parcel” or lipoprotein that carries cholesterol, not the cholesterol molecule itself.
• “It’s the address label... called apolipoprotein B... that enables it to cross over into the lining of our blood vessels.” — Sarah Berry [04:35]
• The process of LDL entering arterial walls leads to plaque formation and increased cardiovascular risk.

4. Debunking the Low-Fat Myth

[05:39–06:53]

• Cutting out all fat doesn’t necessarily reduce cholesterol or improve heart health. In fact, it can be counterproductive.
• “The fact that it's still a myth out there is really blooming irritating. So let’s debunk that.” — Sarah Berry [04:12]
• What matters is the type of fat consumed, not just the amount. Healthy fats (e.g., polyunsaturated fats) are beneficial.

5. Problems with “Low Fat” Labelled Foods

[05:55–06:57]

• Foods labeled “low,” “no,” or “reduced” fat often contain added sugars or other unhealthy ingredients to compensate for changed taste and texture.
• “When you take the fat out, you’re going to have to add lots of stuff to it and... you're creating a food that's very high in these unfavorable types of carbohydrates.” — Sarah Berry [06:06]
• Highly processed, refined carbohydrates are “less healthy for us,” and can worsen cholesterol.

6. Carbohydrates: The Good, the Bad, and the Oats

[06:57–09:03]

• Not all carbs are equal. Whole grains and fibers (especially soluble fibers) help reduce cholesterol.
• “If you increase your whole grain intake, you can reduce your cholesterol levels... increase your fiber intake, you can significantly reduce your cholesterol levels.” — Sarah Berry [07:58]
• Soluble fiber (esp. beta glucans, found in oats and legumes) prevents cholesterol absorption.
  • “Beta glucan is a type of soluble fiber... these can significantly reduce our cholesterol.” — Sarah Berry [08:29]
• Insoluble fiber interacts with the gut microbiome, which may also impact cholesterol.

7. Plant Sterols and Stanols

[09:58–10:51]

• Present in all plants, sterols and stanols can reduce cholesterol, but effective amounts (~2g/day) are hard to get from diet alone.
• Fortified products exist, but are expensive. Sarah suggests focusing first on increasing healthy fats and fiber.

8. The Role and Timing of Statins

[10:51–13:56]

• Statins are effective at lowering cholesterol and reducing cardiovascular risk.
• Diet should be the first line of approach for those at moderate risk: increase polyunsaturated fats, fiber, legumes; reduce refined carbs.
• “Diet changes cholesterol really quickly… you see a change in cholesterol after about 10 days… within a month, you’ve seen a huge change.” — Sarah Berry [12:21]
• It's the duration of elevated LDL that matters: “If you reduce your LDL cholesterol by 1 millimole over 10 years, you reduce your risk by 25%. If you reduce it over 50 years, you reduce it by 50%.” — Sarah Berry [13:19]

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Notable Quotes & Memorable Moments

• On Dietary Cholesterol:
  “The cholesterol that we eat... actually has very minimal impact on the cholesterol that circulates in our blood.” — Sarah Berry [02:14]
• On the Low-Fat Label:
  “I’m always cautious of any label that says low, no or reduced, because what’s been taken out, or rather what’s been added in?” — Sarah Berry [05:55]
• On Carbohydrates:
  “We should not do it at the expense of whole grains... We must do it at the expense of these refined kind of white carbohydrates.” — Sarah Berry [06:57]
• On Rapid Effects of Diet:
  “Diet changes cholesterol really quickly... within a month, you’ve seen a huge change.” — Sarah Berry [12:21]

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Practical Takeaways

• Don't fear all fats: Focus on healthy fats like polyunsaturated and monounsaturated fats.
• Be wary of “low fat” processed foods: They often contain added sugars and unhealthy refined carbs.
• Include more whole grains, legumes, and especially soluble fiber (e.g., oats) in your diet to improve cholesterol.
• For cholesterol reduction, small, sustained dietary changes matter and can make an impact within weeks.
• Diet first; consider medications like statins in consultation with a doctor if lifestyle changes aren’t enough, especially for high-risk individuals.

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Timestamps for Important Segments

• 00:46: What is cholesterol and why do we need it?
• 02:14: Dietary cholesterol vs. blood cholesterol
• 03:40: LDL and HDL explained; why LDL is “bad”
• 05:39: The myth of cutting out all fat for cholesterol
• 05:55: “Low fat” foods and why labels can be misleading
• 06:57: Whole grains, soluble fiber, and carbohydrates’ effects on cholesterol
• 09:58: Plant sterols and stanols: what are they, and do they work?
• 10:51: Statins vs. diet: how to approach cholesterol management
• 12:21: How fast can your cholesterol change with diet?
• 13:19: The long-term impact of cholesterol management

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Conclusion

This recap demystifies cholesterol, emphasizes the importance of understanding food labels, and makes a strong case for favoring real, minimally processed foods rich in healthy fats, fiber, and whole grains. Quick-fix “low fat” products often miss the mark, while small, informed dietary changes can yield significant positive effects for heart health in a matter of weeks.

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Transcript

[A]

Hello and welcome to Zoe Recap, where each week we find the best bits from one of our podcast episodes to help you improve your health. Today we're talking about cholesterol. If you're a regular listener of this podcast, you'll know that our cholesterol level is closely linked to heart health. With that in mind, it's easy to be drawn to foods labeled as low fat, reduced fat, or fat free, all of which seem to promise to keep our cholesterol low and our heart strong. However, is it really that simple? I'm joined by Professor Sarah Berry to break down the difference between good and bad cholesterol, bust myths about low fat foods, and explain how we can make smarter food choices that support our heart.

[B]

So cholesterol is a type of lipid. So it's a type of fat that circulates in our blood and that we can also eat as well. And it's a waxy kind of substance, and it's something that's actually necessary for us. It plays a really important role in our body. So we need it to make many different hormones. We need it to make vitamin D, we need it to make bile acids that are essential for the absorption of fat. And actually, it's a component of every cell membrane in our bodies.

[A]

Every single cell has that.

[B]

Yes, has cholesterol. So without cholesterol, we would be in a little bit of trouble.

[A]

And so if I understand, in fact, total, like, we have to have it, we wouldn't live without it.

[B]

Yeah. And that's why our body makes it. You know, our bodies are so clever. So we don't make things that are bad for us just for the fun of it. It's where these natural processes become a little bit disbalanced. It's just where the problem comes in. But cholesterol is an essential part of our normal physiological functioning.

[A]

And when we often hear about cholesterol, we also hear about it being in food we can eat. Is that the same cholesterol or is that something different?

[B]

So it's slightly different, but more importantly, the way it impacts our health is very, very different. And so what we know is that dietary cholesterol, so the cholesterol that we eat, that is found in many foods. But for example, we might think of some foods as being very high, like eggs, actually has very minimal impact on. On the cholesterol that circulates in our blood.

[A]

Got it. So it's not just the cholesterol in my blood is a result of the food that I eat.

[B]

No.

[A]

So if cholesterol is like, necessary, and it's floating around inside our bodies. I guess my obvious question is, what's it doing in our blood? Cause that's where I think the doctors are measuring it and getting concerned. And why is some of it considered bad?

[B]

Yeah, so we know that there's some type of cholesterol which we call LDL cholesterol is bad for us. And we know there's some type of cholesterol which we call HDL cholesterol is good for us. But as always, Jonathan, it's not quite so simple as that. When we talk about LDL cholesterol and HDL cholesterol, we're actually talking about the packages that the cholesterol is in. So LDL cholesterol stands for low density lipoprotein. So that's the kind of package that it's in. It's the parcel that it's in. Liquid HDL cholesterol basically refers to cholesterol that's packaged in a high density lipoprotein parcel. So you've got these two different parcels, but they actually contain the same type of cholesterol. But it's how they're packaged. And where it becomes really interesting is the label. So the address label that's put on these packages is where actually it becomes really interesting in relation to disease.

[A]

So how does this fit with what we eat? Because, you know, one thing I would have thought listening to this is, well, if I'm worried about my cholesterol, I just won't eat any fat. So I can't have any fat in my body. So I'm going to be really healthy. But you just said at the beginning, actually if you eat certain sort of fats, your cholesterol might get better. And you also said if you didn't eat any fat and you just ate carbs, it could get worse. So how does that fit with this good and bad chlorot?

[B]

So this is one of the big myths that actually cutting out your fat reduces your cholesterol is nonsense. And the fact that it's still a myth out there is really blooming irritating. So let's debunk that. What we want to do is we want to reduce our LDL cholesterol. We want to reduce the cholesterol that's circulating in these bad particles. What we want to ideally do is increase our HDL cholesterol. So the cholesterol that's circulating in these good particles, and the reason we want to do that, very simply put, is because the cholesterol that's Packaged in LDL is the cholesterol that is circulating in our blood and delivered to our peripheral tissues. It's delivered to along our arteries where it can be actually taken up into the arterial wall. The LDL particles have a particular label on them which is called the apolipoprotein B label. So it's got like this address label saying that the receptors on the lining of our blood vessels recognize that enables it to cross over into the lining of our blood vessels. Because of this address label as a way of describing it, called apolipoprotein B, it's then taken up by the lining of the blood vessels. Over time, this causes this atherosclerosis. So this furring which causes the narrowing of the blood vessels. And over time, you can get plaque formation. These can become unstable, These can then burst, and that's when you get a blockage which causes a heart attack.

[A]

What about foods that say low fat on the label? Because again, this is one of the big things that, you know, lots of people even today have been sort of given that advice as a way to try and navigate to, like, a better diet for their cholesterol.

[B]

So I'm always cautious of any label that says low, no or reduced, because what's been taken out, or rather what's been added in in order to create a food that still functions in the same way. When it says low, no or reduced, fat actually has a really important role for food. Not just because it's important for our bodies, but actually it's what carries the flavor and the texture of food. So I don't know if you've ever tried, like, low fat cheese or, you know, low fat. It just doesn't taste the same. It's the fat that gives it that beautiful kind of mouth feel and flavor. And so it' in order to retain some of the pleasure of a food, when you take the fat out, you're gonna have to add lots of stuff to it and a lot of the stuff that's added to it. Firstly, we don't know how it impacts our health. But secondly, what tends to happen is you're creating a food that's very high in these unfavorable types of carbohydrates.

[A]

So they sort of put in lots of sugar to compensate for taking out the fat, for example.

[B]

Yeah, I mean, it depends on the type of food, but often, yes, they're often less healthy for us. I do think, Jonathan, while we talk about carbohydrates, it's really important not to demonize all of them because we know that whole grain carbohydrates. So if we think of whole grain bread, for example, we know that whole grains actually do have a beneficial effect in terms of our cholesterol. So whilst I'm very pro increasing the types of healthy fats in our diet, we shouldn't do it at the expense of whole grains. We must do it at the expense of these refined kind of white carbohydrates.

[A]

So you're just to make sure that I'm picking up on that, right? You're saying it's not like all carbohydrates are bad for your ldl. You're talking about these ones that are highly processed, that can be. Or that just get turned, you know, like a potato or something gets turned into sugar in your blood really fast because then it's like your body's going to end up saying, oh, there's too much of this and I'm going to start creating fats and. Or store it in my fat.

[B]

Yeah, absolutely. We know that if you increase your whole grain intake, you can reduce your cholesterol levels. We also know if you increase your fiber intake, you can significantly reduce your cholesterol levels. And fibre is one of these really important components of that portfolio diet that I mentioned, particularly something called soluble fiber. So many people have heard of something called beta glucans. I don't know if you've heard of that.

[A]

Go on, Sarah. Many people who you hang out with will have heard of beta glucans. I'm going to. I'm going to be the voice of many of our listeners saying, beta what?

[B]

Okay, so beta glucan is a type of soluble fiber. So you've got two different types of fibre. You've got soluble fibre, insoluble fibre, soluble fiber, such as beta glucans. That's found in oats, but there's other soluble fiber found, for example in legumes, you know, beans, that sort of things pulses, which is why they're so good as well for our cholesterol. These particular types of fiber can significantly reduce our cholesterol, as so having a decent amount of those can reduce our cholesterol.

[A]

And is that back to helping feed the right sort of bacteria in our gut or. We just don't really know why this is happening.

[B]

So we know that with soluble fiber, the reason it's beneficial is because actually it changes how we absorb cholesterol. So we know a very. There's a very distinct mechanism for that. But we know that insoluble fiber, which is the fibre that does reach our gut is that improves our cholesterol via the gut microbiome. And so adding oats, for example, daily to our diet. But I'd have to caution that with a massive it needs to be the right kind of oats increases our beta glucan to the extent that therefore you can reduce your cholesterol. But I would caution against having the kind of oats that are heavily refined against that. We also know that there's other dietary changes we can make as well as we can reducing our refined carbohydrates as well as increasing our fat, healthy fat intake. And the other that's often talked about is adding sterols and stanols to our diet.

[A]

I haven't seen them in the grocery store last time I checked.

[B]

So they're actually part of every plant that we eat.

[A]

Okay.

[B]

And they act a little bit in the same way as the soluble fiber. So kind of preventing the absorption of cholesterol. However, you have to have a certain amount of them. You have to have about 2 grams a day in order for it to be beneficial. It's very difficult to get that on a plant based diet. You might get near to that, but it's actually quite difficult. Even if you're on a fully plant based diet. You can buy products that contain these and these are your sterile and stanol kind of shot drinks that you get. So you might have heard of like flora, proactive, etc. And so to get the required amount, you do need to really be buying these kind of products. They're very expensive. And so for someone that is really concerned about their cholesterol, I might often suggest they try. But I would say as a starting point, actually increase the amount of polyunsaturated fats in your diet.

[A]

I feel like that's a natural transition. You've gone from food to something that's starting to feel like a supplement. That's moving then to medicine. We had many, many questions about statins and so I'd love to sort of wrap up with that. Many people will either be thinking about taking them, offered them, or on them. What are your thoughts?

[B]

So I need to caveat that as I'm often caveating with that. I'm not a medical doctor and I don't think I'm comfortable making a decision on whether someone should or shouldn't go on statins. I think it's something that you need to do in consultation with your clinician. I think you need to look at what your current cholesterol level is as well as your overall Cardiovascular disease risk is, I think the evidence for their effectiveness is overwhelming. That's one thing I'll say from a kind of research perspective, it's undoubtedly they reduce your cholesterol. I do think for people that don't have excessively high cholesterol, that they could start by looking at their diet, given that we know that diet can have such a big impact on cholesterol. So I would suggest if someone was to ask me what's my personal view, but please, this is not a medical opinion that look at your diet first. Can you increase your polyunsaturated fat intake? Can you increase your fiber intake? Can you reduce your refined carbohydrate intake? You know, can you increase the amount of legumes you're having? Beans, pulses, et cetera? And try that for a few weeks and see what happens. The good news is, Jonathan, diet changes cholesterol really quickly. We see a change in cholesterol after about 10 days. When people are following a kind of diet that reduces cholesterol within two weeks, you see quite a big change. Within a month, you've seen a huge change. So you can make these changes and then go back to your GP and see a month later, has it significantly reduced your cholesterol? If it's still alarmingly high, that's when I think you need to continue that discussion about statins with Zoe. The program involves small changes that accumulate over time because we know that making small changes are the changes that are going to stick. So if you're making small changes that you progressively add to overtime, then I would suggest waiting two to three months till you go back to check if you are going all out. And this is what we do in our studies, then you will see it quite quickly. But the reason I'm emphasizing how quick it is is because I think it's a really good motivational factor to say, look, you can quickly change it. And I think a really important point to make as well, Jonathan, is that it's the duration over the years at which your LDL cholesterol is elevated that's important in terms of cardiovascular disease risk. So I said earlier that if you reduce your LDL cholesterol by 1 millimole over 10 years, you reduce your risk by 25%. If you reduce it over 50 years, you reduce it by 50%. What we want to be doing is making sure there's less time that you have with an elevated LDL cholesterol.

[A]

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